Tuesday, January 17, 2012

Housemen: Experiential Learning

What an excellent article. Words of wisdom from someone experienced and qualified enough to comment on current HO training. Good read!
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"..There is a common misconception, even among housemen, that because housemen are being paid, they are working. This is not true.
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Firstly, they are in training and have limited privileges and responsibilities.
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Only after satisfactorily completing their training are they allowed to work as a doctor.
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Secondly, the training of housemen, including duration of duty, should be decided by technocrats and professionals and not by the public or politicians.
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This is because, as with other professions, fellow professionals will know best the requirements to develop the skills, knowledge and attitude to enter the realm of unsupervised practice of medicine.
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Let me give a background information about housemanship training, which involves not just cognitive and psychomotor skills development, but also requires exposure to situations and extremes. The American Graduate Medical Education's statement reinforces this point: "Residency is an essential dimension of the transformation of the medical student to the independent practitioner along the continuum of medical education. It is physically, emotionally and intellectually demanding, and requires longitudinally-concentrated effort on the part of the resident."
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This form of training is best summed up as "experiential learning".
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It means that learning and development are achieved through experience and involvement, by observation, listening, study of theory, or some other transfer of skills or knowledge.
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In short, the training of doctors from students to housemen to doctors is a complicated process and should not be discussed publicly.
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An analogy would be the training of airline pilots: the training hours or training conditions are debated by the public because it is considered a complex subject.
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If I may boldly say, the training of doctors is far more complicated with more complex variables.
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Thirdly, the negative implication of such comments is that it encourages housemen to work according to a fixed schedule, which is against the spirit of experiential learning.
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..The guidelines from the Health Ministry on housemen training serve only as an assist, which is what guidelines are supposed to do, but this is poorly understood by many people. This reinforces the fact that training is best decided by professionals, especially those working at that particular place..."

You can read the full article HERE.

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